Patho Midterm 22,23,24, & 25 STUDY!!!
Viral pneumonia is characterized by a.A productive cough b.Exudative consolidation c.Significant ventilation-perfusion imbalance. d.A dry cough
A dry cough
Decreased neuromuscular excitability is often the result of a.Hypercalcemia and hypermagnesemia b.Hypomagnesemia and hyperkalemia c.Hypocalcemia and hypokalemia d.Hypernatremia and hypomagnesemia
Hypercalcemia and hypermagnesemia
Respiratory alkalosis is caused by a.Hyperventilation b.Pneumonia c.Chest muscle weakness d.Pulmonary edema
Hyperventilation
Metabolic alkalosis is often accompanied by a.Hypokalemia b.Hyponatremia c.Hypernatremia d.hyperkalemia
Hypokalemia
Respiratory acidosis may be caused by a.Hyperventilation b.Massive blood transfusion c.Hypoventilation d.Tissue hypoxia
Hypoventilation
When exposed to inhaled allergens, a patient with asthma produced larger quantities of a.IgM b.IgE c.IgA d.IgG
IgE
The finding of ketones in the blood suggests that a person may have a.Metabolic acidosis b.Respiratory acidosis c.Metabolic alkalosis d.respiratory alkalosis
Metabolic acidosis
The organism that causes pulmonary tuberculosis is a.Mycobacterium tuberculosis b.Mycococcidio tuberculosis c.Tuberculosis tuberculosis d.Hemophilus tuberculosis
Mycobacterium tuberculosis
Causes of metabolic acidosis include a.Tissue anoxia b.Massive blood transfusion c.Hyperventilation d.Hypoventilation
Tissue anoxia
The fraction of total body water (TBW) volume contained in the intracellular space in adults is a.Three fourths. b.Two thirds 2/3 c.One third d.One half
Two thirds 2/3
Osmoreceptors located in the hypothalamus control the release of a.vasopressin (antidiuretic hormone, ADH). b.atrial natriuretic peptide. c.aldosterone. d.angiotensin.
Vasopressin (antidiuretic hormone, ADH)
A patient has a positive Chvostek sign. The nurse interprets this as a sign of a.hypercalcemia b.hypermagnesemia c.increased neuromuscular excitability d.decreased neuromuscular excitability
increased neuromuscular excitability
A known cause of hypokalemia is a.oliguric renal failure b.insulin overdoes c.pancreatitis d.hyperparathyroidism
insulin overdose
Emesis caused by a.respiratory alkalosis b.respiratory acidosis c.metabolic alkalosis d.metabolic acidosis
metabolic alkalosis
The characteristics x-ray findings in tuberculosis include a.Tracheal deviation b.Bibasilar infiltrates c.Diffuse white-out d.Ghon tubercles
Ghon tubercles
The nurse provides teaching regarding dietary intake of potassium to avoid an electrolyte imbalance when a patient a.Experiences anorexia and chronic oliguric renal failure b.Has fatty stools from taking an OTC weight loss product that decreases absorption of fat c.Has chronic heart failure that is treated with diuretics d.Takes very large doses of vitamin D to supplement during chemotherapy for breast cancer.
Has chronic heart failure that is treated with diuretics
The patient who requires the most careful monitoring for development of metabolic acidosis is a patient who a.Has had diarrhea for over a week b.Has newly diagnosed Cushing syndrome c.Is in the diuretic phase of acute renal failure. d.Has had hypokalemia for over a week
Has had diarrhea for over a week
Early manifestations of a developing metabolic acidosis include a.Headache. b.Coma. c.Muscle cramps d.Short and shallow respirations
Headache.
The imbalance that occurs with oliguric renal failure is a.Hypophosphatemia b.Hyperkalemia c.Metabolic alkalosis d.Hypokalemia
Hyperkalemia
Which disorder is caused by inhalation of organic substances? a.Diffuse interstitial lung disease b.Hypersensitivity pneumonitis c.Sarcoidosis d.Acute respiratory distress syndrome
Hypersensitivity pneumonitis
Respiratory alkalosis is caused by a.Pulmonary edema b.Chest muscle weakness c.Hyperventilation d.pneumonia
Hyperventilation
Which electrolyte imbalances cause increased neuromuscular excitability? a.Hypocalcemia and hypomagnesemia b.Hypokalemia and hyperphosphatemia c.Hyperkalemia and hypophosphatemia d.Hypercalcemia and hypermagnesemia
Hypocalcemia and hypomagnesemia
A person who overuses magnesium-aluminum antacids for a long period of time is likely to develop a.Hypophosphatemia b.Hyperkalemia c.Hypokalemia d.Hyperphosphatemia
Hypophosphatemia
Abnormalities in intracellular regulation of enzyme activity and cellular production of ATP are associated with a.Hypophosphatemia b.Hypocalcemia c.Hyponatremia d.Hypokalemia
Hypophosphatemia
The body compensates for metabolic alkalosis by a.Hypoventilation b.Increasing bicarbonate ion excretion c.Decreasing arterial carbon dioxide d.Hyperventilation
Hypoventilation
The hallmark manifestation of acute respiratory distress syndrome is a.Hypoxemia b.Frothy secretions c.Tachycardia d.Hypotension
Hypoxemia
Allergic (extrinsic) asthma is associated with a.Irreversible airway obstruction b.IgE-mediated airway inflammation c.Unknown precipitating factors d.Hyperresponsiveness of airways.
IgE-mediated airway inflammation
A major risk factor for the development of active pulmonary tuberculosis (TB) disease is a.Contaminated water b.Immunosuppression c.Being male d.Overuse of antibiotics
Immunosuppression
What age group has a larger volume of extracellular fluid than intracellular fluid? a.Infants b.Adolescents c.Young adults d.Older adults
Infants
In individuals who have asthma, exposure to an allergen to which they are sensitized leads to which pathophysiologic event? a.Loss of alveolar elastin and premature closure of airways b.Mast cell degranulation that causes decreased surfactant c.Inflammation, mucosal edema, and bronchoconstriction d.Pulmonary edema and decreased alveolar compliance
Inflammation, mucosal edema, and bronchoconstriction
The primary cause of infant respiratory distress syndrome is a.Maternal illegal drug use during pregnancy b.Lack of surfactant c.Umbilical cord compression d.Prematurity
Lack of surfactant
A person with acute hypoxemia may hyperventilate and develop? a.Respiratory acidosis b.Respiratory alkalosis c.Metabolic alkalosis d.Metabolic acidosis
Respiratory alkalosis
Which is indicative of a left tension pneumothorax? a.Absent breath sounds on the left b.Respiratory acidosis c.Tracheal deviation to the left d.Course crackles throughout the left chest
Absent breath sounds on the left
Widespread atelectasis, non-cardiogenic pulmonary edema, and diffuse, fluffy alveolar infiltrates on chest radiograph are characteristic of a.Asthma b.Chronic obstructive pulmonary disease c.Acute respiratory distress syndrome d.Cor pulmonale
Acute respiratory distress syndrome
After evaluation, a child's asthma is characterized as "extrinsic" This means that the asthma is a.Of unknown pathogenesis b.Associated with specific allergic triggers c.Associated with respiratory infections d.Induced by psychological factors (stress)
Associated with specific allergic triggers
A patient with a productive cough and parenchymal infiltrates on x-ray is demonstrating symptomology of a.Tuberculosis b.Viral pneumonia c.Bacterial pneumonia d.Acute respiratory distress syndrome.
Bacterial pneumonia
A patient with a productive cough and parenchymal infiltrates on x-ray is demonstrating symptomology of a.Viral pneumonia b.Tuberculosis c.Acute respiratory distress syndrome d.Bacterial pneumonia
Bacterial pneumonia
The major buffer in the extracellular fluid is a.Hemoglobin b.Bicarbonate c.Albumin d.Phosphate
Bicarbonate
Signs and symptoms of extracellular fluid volume excess include a.Increased serum sodium concentration b.Bounding pulse c.Tachycardia d.Increased hematocrit
Bounding pulse
The inward-pulling force of particles in the vascular fluid is called _____ pressure. a.Interstitial osmotic b.Capillary osmotic c.Capillary hydrostatic d.Interstitial hydrostatic
Capillary osmotic
Which acid are the kidneys unable to excrete? a.Metabolic b.Bicarbonate c.Ammonia d.Carbonic
Carbonic
Manifestations from sodium imbalances occur primarily as a result of a.Cellular fluid shifts b.Vascular collapse c.Hypervolemia d.Hyperosmolarity
Cellular fluid shifts
Causes of hypomagnesemia include a.Hyperphosphatemia b.Chronic alcoholism c.Clinical dehydration d.Oliguric renal failure
Chronic alcoholism
Effects of hypernatremia on the central nervous system typically include a.Insomnia b.Confusion c.Hallucinations d.excitation
Confusion
Which clinical manifestation is not likely the result of a tuberculosis infection? a.Low-grade fever b.Productive cough c.Cyanosis d.Night sweats
Cyanosis
Total body water in older adults is a.Increased because of decreased adipose tissue and decreased bone mass b.Decreased because of increased adipose tissue and decreased muscle mass. c.Increased because of decreased renal function and hormone fluctuations d.Decreased because of renal changes that cause diuresis with sodium exretion
Decreased because of increased adipose tissue and decreased muscle mass.
Which alterations can lead to edema? a.Decreased lymphatic flow b.Decreased capillary membrane permeability c.Decreased capillary hydrostatic pressure d.Increased capillary colloid osmotic pressure
Decreased lymphatic flow
A restrictive respiratory disorder is characterized by a.Decreased residual volume b.Expiratory wheezing c.Inspiratory wheezing d.Increased total lung capacity
Decreased residual volume
Excessive antidiuretic hormone (ADH) secretion can cause _____ Concentration. a.Decreased serum sodium b.Increase serum sodium c.Increase serum potassium d.Decrease serum potassium
Decreased serum sodium
Signs and symptoms of clinical dehydration include a.Increased blood pressure b.Decreased urine output c.Increased skin turgor d.Decreased heart rate
Decreased urine output
Clinical manifestations of severe symptomatic hypophosphatemia are caused by a.Deficiency of ATP b.Excess proteins c.Hypocalcemia d.Renal damage
Deficiency of ATP
To best prevent emphysema, a patient is instructed to stop smoking since cigarette smoke a.Impairs al-antitrypsin, allowing elastase to predominate. b.Paralyzes the cilia, causing impaired mucociliary clearance c.Introduces carcinogens into the lungs d.Predisposes to respiratory infections
Impairs al-antitrypsin, allowing elastase to predominate.
If an individual has a fully compensated metabolic acidosis, the blood pH is a.Either high or low, depending on the type of compensation b.Low c.In the normal range d.High
In the normal range
Respiratory acidosis is associated with a.Increased carbonic acid b.Increased neuromuscular excitability c.Hypokalemia d.Increased pH
Increased carbonic acid
Uncompensated metabolic alkalosis would result in a.Increased pH, decreased HCO3- b.Decreased pH, increased HCO3- c.Increased pH, Increased HCO3- d.Decreased pH, decreased HCO3-
Increased pH, Increased HCO3-
Chronic bronchitis often leads to cor pulmonale because of a.Ventricular hypoxia b.Hypervolemia c.Left ventricular strain d.Increased pulmonary vascular resistance
Increased pulmonary vascular resistance
The increased anterior-posterior chest diameter associated with obstructive lung disease is caused by a.Increased pulmonary blood flow b.Decreased chest wall compliance c.Increased residual lung volume d.Increased expiratory flow rates
Increased residual lung volume
Which assessment would support a diagnosis of type A COPD rather than type B COPD a.Normal PaCO2, scant sputum, accessory muscle use, barrel chest b.Noisy breath sound, fatigue, high PaCO2, overweight c.Barrel chest, productive cough, cyanosis, very decreased PaO2 d.Copious sputum, dyspnea, cor pulmonale
Normal PaCO2, scant sputum, accessory muscle use, barrel chest
A person who experiences a panic attack and develops hyperventilation symptoms may experience? a.Numbness and tingling in the extremities. b.Neuromuscular depression c.Acute compensatory metabolic acidosis d.Anxiety acidosis
Numbness and tingling in the extremities.
Asthma is categorized as? a.Type of acute tracheobronchial obstruction b.Obstructive pulmonary disorder c.Restrictive pulmonary disorder d.Infective pulmonary disorder
Obstructive pulmonary disorder
The process responsible for distribution of fluid between the interstitial and intracellular compartments is a.Filtration b.Osmosis c.Active transport d.Diffusion
Osmosis
Obstructive sleep apnea would most likely be found in a patient diagnosed with a.Myasthenia gravis b.Pickwickian syndrome c.Pneumonia d.Poliomyelitis
Pickwickian syndrome
Accumulation of fluid in the pleural space is called a.Flail chest b.Pleural effusion c.An abscess d.Pleurisy
Pleural effusion
Individuals who have chronic bronchitis most often have a.Barrel chest b.Productive cough c.Substantial weight loss d.Normal lung sounds
Productive cough
All obstructive pulmonary disorders are characterized by a.Resistance to airflow b.Decreased residual volumes c.Decreased lung compliance d.Hyperresponsiveness
Resistance to airflow
A patient diagnosed with chronic compensated heart failure reports that, "My feet swell if I eat salt but I don't understand why" The nurse's best response is a. "Gravity makes more pressure down by your feet than up at the top of your body, so more fluid leaks into your tissues at your feet and they swell." b. "Salt makes your blood vessels relax and the blood does not flow as fast, so some of it leaks into your tissues and makes swelling." c. "Salt holds water in your blood and makes more pressure against your blood vessels, so fluid leaks out into your tissues and makes them swell." d. "Salt binds to the proteins in your blood and changes the osmotic pressure so more fluid can leak out and stay in the tissues, causing swelling."
Salt hold water in your blood and makes more pressure against your blood vessels, so fluid leaks out into your tissues and makes them swell.
How is a patient hospitalized with a malignant tumor that secretes parathyroid hormone-related peptide monitored for the resulting electrolyte imbalance? a.Serum calcium, Chvostek and trousseau signs b.Serum calcium, bowel function, level of consciousness c.Serum potassium, Chvostek and trousseau signs d.Serum potassium, bowel function level of consciousness
Serum calcium, bowel function, level of consciousness
Clinical manifestations of extracellular fluid volume deficit include a.Weak pulse, low blood pressure, and increased heart rate. b.Thirst, dry mucous membranes and diarrhea c.Cardiac dysrhythmias, paresthesia, and muscle weakness d.Confusion, lethargy, coma and perhaps seizures
Weak pulse, low blood pressure, and increased heart rate.
A patient exhibiting respiratory distress as well as a tracheal shift should be evaluated for a.Pneumothorax (noomuhthawraks) b.Pulmonary edema c.Pneumonia c.Pulmonary embolus
a.Pneumothorax (noomuhthawraks)
The person at highest risk for developing hypernatremia is a person who a.receives tube feeding because he or she is comatose after a stroke b.self-administers a daily tap water enema to manage a partial bowel obstruction c.is receiving IV 0.9% NaCl at a fast rate. d.Has ectopic production of ADH from small cell carcinoma of the lung.
receives tube feeding because he or she is comatose after a stroke
Croup is characterized by a.an inability to cough b.A barking cough c.A productive cough d.Drooling, sore throat, and difficulty swallowing
A barking cough
Cystic fibrosis is associated with a.Emphysema b.Chronic bronchitis c.Bronchiectasis d.Asthma
Bronchiectasis
Copious amounts of foul-smelling sputum are generally associated with a.Epiglottitis b.Emphysema c.Pulmonary edema d.bronchiectasis
Bronchiectasis
How do clinical conditions that increase vascular permeability cause edema? a.By causing movement of fluid from the vascular compartment into the intracellular compartment which lead to cell swelling b.By allowing plasma proteins to leak into the interstitial fluid, which draws in excess fluid by increasing the interstitial fluid osmotic pressure. c.Through altering the negative charge on the capillary basement membrane, which enables excessive fluid to accumulate in the interstitial compartment. d.Through leakage of vascular fluid into the interstitial fluid, which increases interstitial fluid hydrostatic pressure
By allowing plasma proteins to leak into the interstitial fluid, which draws in excess fluid by increasing the interstitial fluid osmotic pressure.
Pneumocystitis is a term that refers to a a.Pneumonia secondary to bladder infection b.Non-infectious inflammation in the lung c.Fungal pneumonia secondary to HIV d.Viral pneumonia found in a transplant recipients.
Fungal pneumonia secondary to HIV
Lack of a-antitrypsin in emphysema causes a.Destruction of alveolar tissue. b.Chronic mucous secretion and airway fibrosis c.Bronchoconstriction and airway edema d.Pulmonary edema and increased alveolar compliance.
Destruction of alveolar tissue.
Hyperaldosteronism causes a.ECV deficit and hyperkalemia b.Excessive water reabsorption without affecting sodium concentration c.ECV excess and hypokalemia d.Hyponatremia and hyperkalemia
ECV excess and hypokalemia
Renal compensation for respiratory acidosis is evidenced by a.Decreased bicarbonate ion concentration b.Elevated carbon dioxide c.Elevated bicarbonate ion concentration d.Decreased carbon dioxide
Elevated bicarbonate ion concentration
What is the likely to lead hyponatremia? a.Frequent nasogastric tube irrigation with water. b.Excess aldosterone secretion c.Insufficient ADH secretion d.Administration of intravenous normal saline
Frequent nasogastric tube irrigation with water
When a client diagnosed with COPD type A asks, 'Why is my chest so big and round?" the nurse responds that a.Loss of elastic tissue in your lungs allows your airway to close and trap air, which makes your chest round." b.Scar tissues in your lungs makes them stiff and fuller of air than usually, which makes your chest round c.Coughing caused by your condition has changed the structure of your airways, which makes your chest round d.Swelling and mucus in your airways causes air to be trapped in your lungs, which makes your chest round
Loss of elastic tissue in your lungs allows your airway to close and trap air, which makes your chest round."
Obstructive disorders are associated with which pulmonary function test results? a.Low expiratory flow rate//////// High residual volume b.Increased expiratory reserve c.Decreased total lung capacity d.Low residual volumes.
Low expiratory flow rate//////// High residual volume
Obstructive disorders are associated with a.decreased total lung capacity. b.low expiratory flow rates. c.low residual volumes. d.increased expiratory reserve volume.
Low expiratory flow rates.
Diarrhea and other lower intestinal fluid losses will contribute to a.Metabolic alkalosis b.Metabolic acidosis c.Mixed acid-base disorders d.Respiratory acidosis
Metabolic acidosis
Diarrhea causes a.Metabolic acidosis b.Respiratory acidosis c.Respiratory alkalosis d.Metabolic alkalosis
Metabolic acidosis
A major cause of treatment failure in tuberculosis is a.Resistant organism b.Immunosuppression c.Noncompliance d.Allergy to drugs used.
Noncompliance
When preparing for the admission of a client diagnosed with bronchiectasis, the nurse will a.Add a box of surgical masks to the nursing supplies near the door. b.Remove the water pitcher to comply with anticipated fluid restrictions c.Put a sputum cup and a box of tissues on the bedside table d.Remove the telephone to reduce myocardial oxygen demand.
Put a sputum cup and a box of tissues on the bedside table
A 3-year-old is diagnosed with starvation ketoacidosis. What signs and symptoms should you anticipate in your assessment? a.Rapid, deep breathing, lethargy, abdominal pain b.Slow, shallow breathing, belligerence, hyperexcitability c.Rapid, deep breathing tremors, elevated blood pressure d.Slow, shallow breathing, numbness and tingling around his mouth
Rapid, deep breathing, lethargy, abdominal pain
Which pulmonary function test result is consistent with a diagnosis of asthma? a.Reduced forced expiratory volume in 1 second (FEV1) b.Increased FEV1 c.Reduced total lung volume d.Decreased functional residual capacity
Reduced forced expiratory volume in 1 second (FEV1)
Which pulmonary function test result is consistent with a diagnosis of asthma? (child) a.Reduced forced expiratory volume in 1 second (FEV1) b.Decreased functional residual capacity c.Reduced total lung volume d.Increased FEV1
Reduced forced expiratory volume in 1 second (FEV1)
Emphysema results from destruction of alveolar walls and capillaries, which is due to? a.Autoantibodies against pulmonary basement membrane. b.Excessive a1-antitrypsin c.Air trapping with resultant excessive alveolar pressure d.Release of proteolytic enzymes, neutrophils and macrophages, from immune cells
Release of proteolytic enzymes, neutrophils and macrophages, from immune cells
The ________ system compensates for metabolic acidosis and alkalosis. a.Renal b.Cardiovascular c.Respiratory d.Gastrointestinal
Respiratory
What form of oral rehydration, bottled water or salty broth, is best suited for a patient who is demonstrating signs of clinical dehydration? a.Salty soup, because it will provide some sodium to help hold the fluid in his blood vessels and interstitial fluid b.Bottled water, because it will rehydrate his cell c.Salty coup because he needs nutrition as well as fluid d.Bottled water because he is so weak that he might choke on the fluid when he swallows
Salty soup, because it will provide some sodium to help hold the fluid in his blood vessels and interstitial fluid
Which change in a patient's assessment has the greatest urgency? a.Serum potassium concentration is decreasing; abdominal distension, but denies any difficulty breathing b.Serum calcium concentration is decreasing; reports constipation; is alert and denies any discomfort c.Serum calcium concentration is increasing; reports constipation; is alert and denies any discomfort d.Serum potassium concentration is increasing; has developed cardiac dysthymia's, but denies any difficulty breathing
Serum potassium concentration is increasing; has developed cardiac dysthymia's, but denies any difficulty breathing
The most definitive diagnostic method for active tuberculosis is acquired via a.Blood culture b.Sputum culture c.Chest x-ray d.Mantoux skin test
Sputum culture
Which complication of asthma is life threatening? a.Status asthmaticus b.Late phase response c.Mast cell degranulation d.Exercise-induced asthma
Status asthmaticus
Air that enters the pleural space during inspiration but is unable to exit during expiration creates a condition called a.Open pneumothorax b.Tension pneumothorax c.Pleural effusion d.Empyema
Tension pneumothorax
Osmoreceptors located in the hypothalamus control the release of a.Vasopressin, antidiuretic hormone, ADH b.Angiotensin c.Atrial natriuretic peptide d.Aldosterone
Vasopressin, antidiuretic hormone, ADH
Fully compensated respiratory acidosis is demonstrated by a.pH 7.36, PaCO2 55, HCO3- 36 b.pH 7.26, PaCO2 60, HCO3- 26 c.pH 7.40, PaCO2 40, HCO3- 24 d.pH 7.45, PaCO2 40, HCO3- 28
pH 7.36, PaCO2 55, HCO3- 36
A patient has been hospitalized several times in 6 months with severe ECV depletion and hypokalemia resulting from chronic laxative abuse. Which blood gas results should be relayed to the physician? a.pH in high part of normal range, PaO2 normal, PaCO2 normal, bicarbonate normal b.pH in low part of normal range, PaO2 normal, PaCO2 lower, bicarbonate low. c.pH in low part of normal range, PaO2 normal, PaCO2 normal, bicarbonate normal. d.pH in high part of normal range, PaO2 normal, PaCO2 high, bicarbonate high
pH in high part of normal range, PaO2 normal, PaCO2 high, bicarbonate high
